MEDICARE: ALECIA MURRAY TULLEY M.S. CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	235Z00000X	Speech-Language Pathologist	5619	SC

General Provider Information

NPI Number	:	1720497894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALECIA MURRAY TULLEY M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	142 SPORTSMAN ISLAND DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29492-8524
Country	:	US
Telephone Number	:	843-696-2174
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 SPORTSMAN ISLAND DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29492-8524
Country	:	US
Telephone Number	:	843-696-2174
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	11/11/2022

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Directions to “ ALECIA MURRAY TULLEY M.S. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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